Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 5 

Evaluating the Success of Your 

Counter-Marketing Program 

To ensure accountability and enable future improvements 

in tobacco control programs, state tobacco control 

programs must be evaluated and have explicit goals 

coupled to performance measures. 

—	 National Cancer Policy Board, 2000 

Evaluation plays a critical role in tobacco counter-marketing campaigns. 

Programs should be evaluated regularly to enable the program manager 

to build on successes, to switch to new strategies if necessary, and to be 

accountable to all those with an interest in the program’s outcome. 

Evaluation can help you to answer questions such as the following: 

■	 What impact is the counter-marketing program having? 

■	 Is the program being implemented as planned? 

■	 Are the audience’s attitudes or beliefs about tobacco being changed 

by the program? 

■	 Is the program helping to improve the health status of the 
 

target population?
 

■	 How can the program be improved? 

■	 Is the funding level appropriate for accomplishing the 
 

program’s objectives?
 

In This Chapter
 

•	 Evaluation and 

Surveillance 

•	 Types of Evaluation 

•	 What Evaluation 

Can Do 

•	 When To Conduct 

an Evaluation 

•	 Scope of the 

Evaluation 

•	 How To Conduct 

an Evaluation 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 109 
Systematic collection of data for evaluation of 

the counter-marketing program can help to 

inform decisions of program managers and 

marketing managers, so the program can be 

improved and its outcomes demonstrated. 

However, this process doesn’t take place in a 

vacuum. You’ll need to define the purpose of 

the evaluation and decide which evaluation 

questions to ask, when evaluation should take 

place, how to present the questions to obtain 

the information needed, and how to provide 

this information to those who need it, in a way 

that facilitates its use. 

An evaluation must be practical and must 

cover issues related to time, money, and the 

political context. For example, the more costly 

and visible the program is, the more comprehensive and rigorous the evaluation may need 

to be. The design of evaluation should be based 

on the expected use of the findings. Furthermore, it should be conducted in an ethical and 

high-quality manner, so results can withstand 

scientific scrutiny (Joint Committee on Standards for Educational Evaluation 1994; Patton 

1997; CDC 2001). 

Evaluation efforts should be planned during 

initial development of the program. Thinking 

about evaluation early improves both the 

program and the evaluation. In addition, most 

outcome evaluation requires a baseline study 

that must be conducted before any program 

activities take place. Evaluation should be 

coordinated with the program’s implementation, so the results are timely and useful. If 

results are given to the program managers as 

they are generated, the managers can make 

adjustments to the program and share results 

with stakeholders. 

CDC offers several resources to help you with 

evaluation. The Evaluation Working Group’s 

Framework for Program Evaluation in Public 

Health (CDC 1999b) provides general 

evaluation guidance. The National Tobacco 

Control Program: An Introduction to Program 

Evaluation for Comprehensive Tobacco Control 

Program Evaluation, from the Office on 

Smoking and Health (OSH) (CDC 2001), 

presents an evaluation approach useful for 

tobacco control programs. CDC/OSH is 

preparing a manual that focuses on outcome 

evaluation specifically for paid counteradvertising campaigns. (Check 

http://www.cdc.gov/tobacco for availability.) 

States may also contact their CDC project 

officers for information about how to obtain 

resources and contact evaluation experts. 

This chapter provides the basics of process and 

outcome evaluation for counter-marketing 

campaigns. It is consistent with the other CDC 

evaluation resources. The chapter addresses 

the difference between evaluation and surveillance, types of evaluation, what evaluation can 

do for you, and the various steps in conducting 

an evaluation. Additional guidance specific to 

each of the counter-marketing components 

can be found in the chapters on those topics 

(Chapter 7: Advertising, Chapter 8: Public 

Relations, Chapter 9: Media Advocacy, Chapter 

10: Grassroots Marketing, and Chapter 11: 

Media Literacy). 

110 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Evaluation and Surveillance 

The terms evaluation and surveillance are 

often used together, but they are distinct 

concepts. Program evaluation is “the systematic collection of information about the 

activities, characteristics, and outcomes of 

programs to make judgments about the 

program, improve program effectiveness, 

and/or inform decisions about future program 

development” (Patton 1997; CDC 2001). 

Surveillance is “the continuous monitoring or 

routine collection of data (e.g., behaviors, 

attitudes, deaths) over a regular interval of 

time” (CDC 2001). The Behavioral Risk Factor 

Surveillance System is an example of 

surveillance based on state data. 

Although you may use surveillance systems 

and program evaluation methods to collect 

data on similar items, these data shouldn’t be 

used for the same purpose. Surveillance data 

can be used to monitor overall trends in a 

population, but they can’t be used to attribute 

observed improvements to a specific program. 

If a program is implemented on a sufficiently 

large scale and consistently across various 

sites, surveillance data can help to validate 

findings from the program evaluation. 

However, states should consider supplementing traditional surveillance systems that 

regularly monitor smoking behaviors and 

other tobacco-related variables with additional 

data collection designed to evaluate state 

counter-marketing programs. 

Types of Evaluation 

Several types of evaluation can help you to 

develop and assess your counter-marketing 

program. Three main types—formative, 

process, and outcome evaluation—form a 

continuum. Formative research and evaluation 

are conducted during program planning and 

development. (See Chapter 3: Gaining and 

Using Target Audience Insights and Chapter 7: 

Advertising for further information.) Formative 

research and evaluation help to answer these 

questions: 

■	 How should I design my program? 

■	 How well designed is each component 

of my program? 

Formative research and evaluation help you to 

decide what to do and how to do it. Formative 

research is used to glean insights about the 

issue and your target audience(s) and to determine which messages and interventions might 

be effective. Formative evaluation is used to 

test concepts, materials, and messages, to 

determine whether they are communicating 

the intended messages and having the desired 

influence on your target audience. 

Process and outcome evaluations, the focus of 

this chapter, are planned during the strategic 

planning stage and conducted during and after 

the implementation stage. Process evaluation 

helps you to answer these questions: 

■	 Are we implementing the program as 

planned, and is it on schedule? 

■	 What are we doing that was not in our 

original plan? 

Process evaluation examines how your 

program is working while it is being implemented. It helps you to determine whether 

you’re implementing with “fidelity”—whether 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 111 
you’re sticking to your original program design. 

For an ad campaign, this evaluation might 

include assessments of whether the ad was 

aired at the times you proposed and whether 

your target group was exposed to the message. 

In addition, you might record unforeseen 

obstacles and potentially confounding environmental events to help you interpret findings. 

For public relations, process evaluation could 

involve documenting whether targeted key 

journalists were reached, the content of the 

pitch, and whether certain planned events took 

place. For a media literacy program, it might 

mean counting how many times the program 

was delivered, finding out if all the curriculum’s 

lessons were implemented, and determining 

whether participants were satisfied with the 

content and delivery. Process evaluation enables 

you to report to stakeholders the plans you are 

implementing and the progress of your efforts. 

Lesson Learned: Coordination 

the expected short-term, intermediate, and 

long-term outcomes. Typically, outcomes are 

expected changes in the audiences targeted for 

the counter-marketing program. For example, 

in an ad campaign, the outcome evaluation 

can show whether there’s any change in the 

target audience’s awareness and recall of the 

message; tobacco-related attitudes, beliefs, 

and other psychosocial factors; and behavior. 

For a grassroots marketing initiative, the 

outcome evaluation can show changes in the 

community’s level of involvement in, and 

commitment to, the program. For a media 

advocacy component, the outcome evaluation 

can assess whether your efforts led to a change 

in tobacco-related policy. For public relations 

activities, your assessment might determine 

whether the target audience was aware of and 

understood the messages in your stories. In 

addition to these expected outcomes, 

unexpected outcomes sometimes arise, and 

these need to be acknowledged and included 

in your evaluation analysis. 

Outcome evaluation helps you to answer the 

question: What effect are we having? It helps 

you to determine whether you’re achieving 

The Mistake: One state didn’t establish a regular working relationship between program staff and 

evaluation staff. The program staff decided to stop running an ad but didn’t tell the evaluation team. The 

evaluation team didn’t check with the program staff to ensure that the ads were continuing to be aired as 

planned and continued to ask audience members, in subsequent waves of advertising awareness research, 

if they had seen the ad. Reported awareness of the ad dropped off, and the evaluation team concluded 

that the ad was ineffective. Fortunately, the mistake was discovered before the research report was widely 

disseminated. 

The Lesson: Establish regular communication and coordination between the program management and 

evaluation teams. 

112 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

What Evaluation Can Do 

Program evaluation has two general purposes. 

First, it helps program managers to revise and 

improve their programs. Second, it helps them 

be accountable to stakeholders, demonstrate 

the value of the investment, and maintain or 

increase support and funding for program 

efforts. Your stakeholders range from state 

administrators, legislators, policy makers, and 

taxpayers, to tobacco control and public 

health decision makers, to your bosses and 

partners. Well-conducted evaluations can: 

■	 Allow you to compare the program’s 

effect among groups, particularly those 

most affected by tobacco’s harms 

■	 Demonstrate the role of effective counter-marketing campaigns in reducing 

tobacco use and exposure to secondhand smoke, thereby gaining credibility 

for the counter-marketing elements of 

the tobacco control program 

■	 Guide administrative decisions about 

including counter-marketing efforts 

in comprehensive tobacco control 

programs 

■	 Provide concrete results that can be 

shared with partners and the community 

■	 Support replication, in your state or 

others, of counter-marketing strategies 

that work 

■	 Advance the field by publishing results 

If you’ve been working in public health for a 

while, evaluation won’t be new to you. You 

evaluate your work all the time when you ask 

questions, consult partners, make assessments 

based on feedback, and then use those judgments to improve your work. Those informal 

processes may be sufficient for regular, ongoing 

assessment needs, but in a statewide tobacco 

counter-marketing program, the stakes are 

usually higher. Most tobacco counter-marketing 

programs affect many people and involve a good 

deal of time and money, so you’ll need to use 

evaluation procedures that are more systematic, 

formal, visible, and justifiable. 

When To Conduct an Evaluation 

As noted earlier, evaluation is a continuous 

activity that needs to be planned along with 

overall program planning. Too often, evaluation is considered to be an “optional activity” 

rather than an integral component of countermarketing that is included in program 

planning from the start. 

In outcome evaluation, the timing of assessments and reports should be coordinated with 

the changes you expect to see in the target 

audience. For example, early in the campaign, 

you should expect changes in awareness and 

recall of your ads’ messages. As the campaign 

matures, you would expect changes in 

attitudes and beliefs. Only after building 

awareness and seeing changes in underlying 

beliefs should you expect changes in intended 

behaviors and claimed behaviors. Behavior 

change, which is reflected by evidence such as 

reduction in smoking prevalence, is most likely 

to occur when counter-marketing is part of a 

more comprehensive tobacco control effort. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 113 
It’s unrealistic to expect that counter-marketing 

efforts alone will lead to substantial changes in 

behavior related to tobacco use. 

Some stakeholders will want the first wave of 

outcome evaluation results within six months 

of launching the program. In this case, your 

first wave of evaluation should concentrate on 

process measures and short-term and intermediate outcome measures (e.g., increases in 

calls to a quitline, improvements in advertising 

awareness, or changes in knowledge) rather 

than longer-term behavior changes. 

Scope of the Evaluation 

Every state should evaluate its countermarketing activities as part of the overall 

evaluation of the tobacco control program. 

CDC recommends that 10 percent of a state’s 

tobacco control funds be allocated to surveillance and evaluation (CDC 1999a). You’ll need 

to decide the best way to allocate the funds 

and how rigorously to evaluate each activity. 

At a minimum, good process evaluation of 

each counter-marketing activity will enable 

the program manager to monitor the scope 

and quality of activities and to determine 

Lesson Learned: Planning 

whether the program is being conducted as 

planned. These results will help you consider 

the realities of conducting the program and 

make adjustments in its design. 

Outcome evaluation is needed to determine 

whether your program is having the intended 

effects. The more rigorous an outcome evaluation is, the more expensive it is, and the more 

difficult it is to conduct. As a rule of thumb, 

you should conduct more rigorous evaluation 

under the following conditions: 

■	 The program is costly, highly visible or 

controversial, or represents a new and 

untested approach. 

■	 Sound methods for rigorous evaluation 

exist. 

■	 Future funding depends on the
 

program’s success. 
 

Because many of these characteristics apply to 

the counter-advertising campaign, you’ll probably want to allocate a significant proportion 

of your evaluation resources to this component of your counter-marketing program. 

Counter-advertising campaigns are new to 

114 

The Mistake: One state didn’t think about evaluation early enough and didn’t do a baseline assessment before 

launching a paid media campaign. Consequently, the state will never know the results produced by the paid 

media campaign. Well-funded, paid media campaigns often produce substantial changes in awareness, 

attitudes, and beliefs shortly after they are run. 

The Lesson: Start planning your evaluation when you start planning the program. Then you can conduct a 

baseline assessment before you begin to implement the program. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

many states, and there is growing demand 

for more rigorous outcome evaluations. 

developed by the CDC Evaluation Working 

Group (CDC 1999b). 

To conduct a systematic evaluation of a 

tobacco counter-marketing program, you 

need to consider several steps. This detailed 

discussion of the steps follows the format 

The evaluation of the counter-marketing 

efforts should be coordinated with the evaluation of the whole tobacco control program. 

Counter-marketing activities are just one 

component of a complete tobacco control 

program, and evaluation can help to show 

whether all activities and components are 

working together effectively. 

Step 1: Identify stakeholders, and 

establish an evaluation team. 

Like planning and implementation, evaluation 

can’t be done in isolation. It involves partnerships. To identify the stakeholders, ask yourself: Who is the audience for the evaluation? 

What do they care about? The CDC Evaluation 

Working Group identified three overlapping 

groups that are integral to program evaluation 

How To Conduct an Evaluation (CDC 1999b): 

■ People involved in the campaign’s 

operation, such as management, 

program staff, partners, the funding 

agency, and coalition members 

Steps for Conducting an Evaluation 

Step 1. Identify stakeholders, and establish an evaluation team. 

Identify and involve those who will use or are affected by the evaluation. 

Step 2. Describe your counter-marketing program. 

Establish the need for an intervention, articulate your goals and objectives, and develop a 

program logic model. 

Step 3. Focus the evaluation design. 

Identify the purpose of the evaluation, develop and prioritize evaluation questions, and choose 

the evaluation study design. 

Step 4. Gather credible evidence. 

Develop outcome measures; identify indicators; select data-collection methods that are 

trustworthy, valid, and reliable; and collect the data. 

Step 5. Justify conclusions. 

Analyze and interpret the data, draw conclusions, and make recommendations. 

Step 6. Ensure use of results and share lessons learned. 

See that results are disseminated and used to inform decisions. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 115 
■	 People served by the campaign, such as 

advocacy groups and members of the 

target audience; elected officials; and 

any others who would be affected if the 

campaign were expanded, limited, or 

ended as a result of the evaluation 

■	 The primary intended users of the 

evaluation or anyone in a position to 

make decisions about the countermarketing efforts, such as health 

department decision makers, public 

health officials, and state legislators 

A Good Evaluator 

appropriate staff from these agencies should 

be involved in the evaluation planning. 

In addition, if you’re working with an ad
 

agency, a public relations agency, or both,
 

Any serious effort to evaluate a program must 

consider the different values stakeholders 

have, ensure that their perspectives are 

understood, and try to respond to their unique 

information needs (Patton 1997). If stakeholders aren’t appropriately involved, it’s more 

likely that evaluation findings will be ignored, 

criticized, or resisted. If they are involved, 

they’re likely to feel ownership and help you to 

gain allies who will defend the evaluation and 

its findings. 

To choose a good evaluator, consider whether the person: 

■	 Has experience evaluating health promotion programs, with particular emphasis on tobacco 
 

control, marketing campaigns, or health communication programs
 

■	 Can provide references (Check all references carefully before you contract with an outside 
 

consultant.)
 

■	 Can walk you through some of his or her recent research projects, to demonstrate skill and 
 

experience
 

■	 Can work with a wide variety of people, from representatives of the target audience to high-level 

public officials 

■	 Develops innovative approaches to evaluation while considering budget limitations and other 

realities 

■	 Complements the in-house evaluation team and increases its evaluation capacity 

■	 Shares all findings with the program staff regularly 

■	 Demonstrates the ability to include cultural competency in the evaluation 

116 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

You can involve stakeholders in the evaluation 

in various ways. The following approach has 

been adapted from the CDC Evaluation 

Working Group’s Framework for Program 

Evaluation in Public Health (CDC 1999b). 

1a: Establish an evaluation team. 

An evaluation team should consist of the 

program manager, external stakeholders, and 

people with evaluation expertise. The program 

manager or someone on the countermarketing staff should act as a liaison with the 

evaluation team and should be responsible for: 

■	 Budgeting for the evaluation 

■	 Developing and communicating program objectives and the logic model 

■	 Managing evaluation contracts 

■	 Coordinating evaluation activities
 

between program staff and the 
 

evaluation team
 

■	 Incorporating evaluation findings into 

program planning and revision 

Although the program manager should be able 

to understand and provide input on evaluation 

activities, he or she will need to find someone 

with the technical expertise to design and 

implement specific evaluation tasks. 

If your health department has personnel with 

technical expertise, they can be part of the 

evaluation team, but you should also involve 

outside evaluation experts. Your countermarketing program—especially the counteradvertising component—will be highly visible 

and possibly controversial, and the audience 

for the evaluation may not view the findings as 

credible unless they’re generated and reported 

by outside experts. Stakeholders often see 

outside evaluators as being neutral and objective and without the vested interests of those 

inside the organization that is implementing 

the program. Technical expertise may be 

available through external partners (e.g., 

organizations, universities, companies, and 

tobacco control programs in other states) or 

through CDC and its Prevention Research 

Centers program. This national network of 24 

academic research centers is committed to 

prevention research (CDC 2001). (Contact 

information is available at www.cdc.gov/prc.) 

States may consult with their CDC project 

officers for advice on finding the appropriate 

outside experts and working with them. 

Step 2: Describe your countermarketing program. 

To effectively plan the evaluation, you’ll need 

to have a clear description of your countermarketing program. This description should 

include background information justifying the 

need for the program, appropriate program 

goals and objectives, and a logic model to help 

define what you hope to achieve and to guide 

the evaluation. Negotiating with stakeholders 

about a concise program description will help 

to gain their support and allow them to 

provide insights that might be useful for 

program planning (Patton 1997; CDC 2001). 

If you followed the guidance in Chapter 2: 

Planning Your Counter-Marketing Program, 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 117 
this step will have already been completed. 

If you have not described your countermarketing program, refer to the planning 

chapter, which offers more information on 

two of the program planning steps that are 

essential to planning an evaluation: articulating program goals and objectives and 

developing a logic model. 

2a: Articulate program goals and 

objectives. 

Before an evaluation can be effectively 

planned, you’ll need to determine what your 

program needs to accomplish and what can be 

realistically accomplished within the budget 

and time frame. If your formative research has 

already been conducted, the findings can be 

helpful here. These results should have allowed 

you to identify the populations most in need 

and the behaviors and behavioral determinants that should be targeted for change. In 

addition, through pretesting of your messages 

and program approaches and your review of 

how similar approaches worked in other 

states, you should have gauged the amount 

of change to expect in your target audience. 

Formative research results should be used to 

determine your program’s goals and objectives. These goals and objectives are also 

critical to the evaluation, because they 

establish how you’ll determine whether your 

program is being implemented as planned and 

how you’ll measure your program’s success. 

A goal is the overall mission or purpose that 

helps to guide a program’s development. In 

tobacco counter-marketing, as with all 

tobacco prevention and control components, 

the overall goal is to reduce tobacco-related 

morbidity and mortality. To fulfill this vision, 

CDC has identified four more specific goals, 

one or more of which will be relevant to your 

program (CDC 2001): 

1. 	 Prevent the initiation of tobacco use 

among young people. 

2. 	 Promote quitting among young people 

and adults. 

3. 	 Eliminate exposure to secondhand 

smoke. 

4. 	 Identify and eliminate the disparities 

related to tobacco use and its effects 

among different population groups. 

Objectives are statements that describe the 

desired results. Tobacco control and prevention 

programs are complex and have multiple steps 

and effects. Select a limited set of objectives 

that will allow you to focus your evaluation on 

the most important results that are feasible to 

obtain. In addition, objectives should be conceptually linked, so that objectives at the local 

level are logical extensions of national and 

state objectives. The specific objectives outlined 

in Healthy People 2010 are a good starting point 

for tobacco control efforts (U.S. Department of 

Health and Human Services 2000, available at 

http://www.health.gov/healthypeople/ 

Document/HTML/Volume2/27Tobacco.htm). 

Good objectives are specific and measurable 

(CDC 2001). Well-written and clearly defined 

objectives will help you to set your program 

priorities, aid you in monitoring progress, and 

serve as targets for accountability. Objectives 

should be SMART: 

118 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■ Specific. The objective must identify 

a specific event or action that will 

take place. 

■	 Measurable. The objective must 

identify the amount of change to be 

achieved, and there must be a way to 

measure the change. 

■	 Achievable. The objective must be 

realistic and achievable. 

■	 Relevant. The objective must be logical 

and relate to the program goal. 

■	 Time-bound. The objective must 

provide a time by which the objective 

will be achieved. 

One example of an objective is that, in a certain 

state, the proportion of restaurants with smokefree policies will increase from 40 percent to 

60 percent by the end of 2005. 

This objective is specific because it states that 

restaurants will have smokefree policies in 

place. It could be made more specific if it 

identified which types of restaurants and 

which types of smokefree policies. It’s measurable because it identifies the current or 

baseline value and a level of change that is 

expected. It’s achievable because it outlines a 

realistic amount of change, assuming a strong 

counter-marketing program focused on this 

objective. The degree to which it’s achievable 

will depend on the context and realities within 

the state and the resources available. It’s 

relevant because having smokefree policies 

will help to eliminate exposure to secondhand 

smoke. It’s time-bound because a specified 

time frame is given. 

There are two general types of objectives: 

process objectives and outcome objectives. 

Process objectives describe the scope and 

quality of the activities that will be implemented and the population and other entities 

(i.e., individuals and organizations) that will 

take part in these activities. A process evaluation examines how well you’re achieving your 

process objectives or how well you’re implementing your program, compared with the 

objectives in the original plan. If you’re conducting a counter-advertising campaign in the 

spring to prevent initiation of smoking among 

youths, process objectives might be: 

■	 By February 2003, pretest an ad countering a tobacco industry message with 

six focus groups of 12-to-17 year-olds. 

■	 By March 2003, run the youth ad on TV 

so that 70 percent of the state’s 12- to 17­

year-olds are potentially exposed to the 

ad a minimum of three times on average 

per four-week period. 

Outcome objectives describe the results you 

expect from the program. They quantify 

anticipated program effects by specifying “the 

amount of change expected for a given health 

problem/condition for a specified population 

within a given time frame” (University of Texas 

1998; CDC 2001). 

Outcome objectives are often divided into 

short-term, intermediate, and long-term 

outcomes (Green and Lewis 1986; Green and 

Kreuter 1999; Green and Ottoson 1999; CDC 

2001). An example of a short-term outcome 

objective might be: Increase the proportion of 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 119 
high school youth with confirmed awareness 

of the youth ad campaign from 5 percent in 

January 2003 to 50 percent in June 2003. 

An example of an intermediate outcome 

objective might be: Increase the proportion of 

high school youth who report they believe that 

the tobacco industry deliberately uses advertising to get young people to start smoking 

from 40 percent in January 2003 to 60 percent 

in December 2003. 

Examples of long-term objectives might be: 

■	 Decrease the proportion of high school 

youth who report smoking a cigarette in 

the past 30 days from 40 percent in 2001 

to 30 percent in 2003. 

■	 Decrease the prevalence of high school 

youth who report smoking five or more 

cigarettes a day from 25 percent in 2001 

to 20 percent in 2003. 

2b: Develop a logic model. 

Developing a logic model of your countermarketing program is a good way to fully 

explain how the program is supposed to work. 

(See Chapter 2: Planning Your CounterMarketing Program for further information on 

developing a logic model.) A logic model is a 

flowchart of your program that shows the 

sequence of events in a chain of causation. 

Elements of a logic model can vary, but they 

generally include the following (United Way of 

America 1996): 

■	 Inputs—what is invested in the program 

to support it 

■	 Activities—the actual events or actions 

that take place 

■	 Outputs—the immediate products of 

these activities 

■	 Outcomes—the intended effects of 

the program, initial, intermediate, and 

long-term 

Some examples of inputs, activities, outputs, 

and outcomes for various components of a 

counter-marketing program are shown in 

Appendix 5.1. The inputs are the monetary and 

human resources needed to do the work and 

the infrastructure required to support the 

program. These factors include funding, staff, 

technical assistance, partner organizations, 

contracts, equipment, materials, and a sound 

program design. The type of staff, amount of 

funding, and program design will often differ 

for each component of your program. 

Activities are the actions the countermarketing staff will take to carry out the 

program. Examples of such actions are 

identifying audiences, writing plans, creating 

and revising materials, contacting individuals 

and organizations, and organizing events. 

Program outputs (sometimes called process 

outcomes) are the immediate products of 

these activities; outputs include ads that are 

run, stories that are placed, events that are 

attended, and media literacy sessions that are 

conducted. 

120 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Figure 5.1: Logic Model for Youth Tobacco Use 

Prevention Advertising Campaign 

Input 

Funds for paid media 

Activity 

Design industry manipulation ad 

Output 

Industry manipulation ad is aired on the 

stations and at the time to reach youth; 

youth are potentially exposed 

Short-Term Outcome 

Youth report awareness of the specific ad 

and react positively to it 

Intermediate Outcome 

Youth are more likely to believe that 
 

tobacco companies try to get people to smoke 

and less likely to believe smoking is cool
 


 

Long-Term Outcome 

Fewer youth report trying 

cigarette smoking 

Outcomes are the results you hope your efforts 


will achieve; they are divided into short-term, 


intermediate, and long-term (Campbell and 


Stanley 1963). More important than the label 


for the outcome, however, is the chain of 


causation linking one outcome logically to 


another. A logic model shows how you expect 


change to occur or how the immediate prod­


ucts of your activities will lead to short-term, 


then intermediate, then long-term outcomes. 


As much as possible, the logic model should 


be tailored to your particular campaign, target 


audience, strategy for influencing behavior, 


and specific behavioral objective. Figure 5.1 


shows an example of a logic model for a 


tobacco counter-advertising campaign 


designed to prevent youth from starting to 


smoke tobacco. The campaign points out that 


the tobacco companies try to influence young 


people to start smoking by convincing them 


that smoking is cool. Appendix 5.1 provides 


other examples of logic models for the 


components of a counter-marketing program. 


Although the sample logic models list 


behavioral outcomes, behavior change 


typically results only through a combination of 


interventions. For example, a media literacy 


program would not be expected to result in a 


reduction in youth smoking unless other 


components of the counter-marketing 


program were also influencing these youth. 


The elements of the logic model are linked in a 


series of if-then statements. If the ad is aired 


on the selected channels, then audience 


members who watch the channel can be 


aware of, comprehend, and react positively to 


Chapter 5: Evaluating the Success of Your Counter-Marketing Program 121 
the ad. If the audience is exposed to, aware of, 

and recalls the ad, then their attitudes, beliefs, 

and other psychosocial factors might change. 

(Psychosocial factors are characteristics such 

as attitudes, beliefs, perceived norms, and selfefficacy that, according to the major theories 

of behavior, are the determinants of people’s 

behavior.) If changes in psychosocial factors 

occur, then one would expect changes in 

behavior. 

This logic model is the model for one type of 

effort, a youth counter-advertising campaign. 

You could also develop a logic model for your 

entire counter-marketing program that shows 

how each component works individually and 

is coordinated into an integrated program. 

Another option is to develop a logic model for 

the entire state tobacco control program that 

shows how the various counter-marketing 

efforts work in combination with the other 

elements of the tobacco control program. 

Some good examples of logic models can be 

found in the CDC/OSH tobacco control 

evaluation manual, Introduction to Program 

Evaluation for Comprehensive Tobacco Control 

Programs (CDC 2001). 

It’s not uncommon for people to have different 

interpretations of the short-term, intermediate, 

and long-term outcomes for a particular 

program. What may be an intermediate 

outcome to some may be a long-term 

outcome to others. For example, one person 

may consider “quitting smoking” to be a longterm outcome for a particular smoking 

cessation program, while another may consider quitting smoking to be an intermediate 

outcome and “long-term abstinence from 

tobacco use” to be the long-term outcome. 

The logical sequence of short-term, intermediate, and long-term outcomes, based on 

your program’s theoretical under-pinnings and 

the types of change that can be expected, is 

more important than the labels. 

There are also different interpretations of how 

program outputs and short-term outcomes are 

articulated in program logic models. In a 

public relations effort, for example, one may 

consider the public relations activities of 

identifying and connecting with key journalists 

to be the program outputs and getting press 

coverage and audience exposure to be a shortterm outcome. Others may consider the PR 

activities, news coverage, and audience exposure all as outputs and the target audience’s 

actual awareness of the counter-marketing 

message as the short-term outcome. Here we 

use the latter interpretation across all countermarketing programs, so that program outputs 

include multiple “products of activities” that 

allow the target audience to be exposed to 

counter-marketing messages and short-term 

outcomes include the target audience’s 

increased awareness of these messages. 

Step 3: Focus the evaluation design. 

An evaluation can easily become too extensive 

and complex. In collaboration with stakeholders, the evaluation team will need to decide 

the evaluation’s purpose and how results will 

be used. The evaluation plan should outline 

the questions you plan to answer, the process 

you’ll follow, what will be measured, which 

methods will be used, who will perform 

various evaluation activities, what you will 

122 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

do with the information after it’s collected, 

and how the results will be disseminated. 

3a: Determine the purpose and 

questions for the evaluation. 

You can help to focus the evaluation by determining the information you need and setting 

priorities for the evaluation questions used to get 

that information. Because the prioritized questions will guide the methods for gathering the 

information, decisions about the questions 

should be made before choosing the methods. 

To prioritize the evaluation questions, the evaluation team should brainstorm with the stakeholders and intended users. You should use your 

process and outcome objectives to guide this 

discussion, so the objectives are linked to the 

questions you want the evaluation to answer. 

Develop evaluation questions for each component of your counter-marketing campaign. One 

study won’t effectively answer all your evaluation 

questions, so consider conducting several studies 

that will make up an evaluation portfolio. Put 

together a table that summarizes the objectives 

Table 5.1: Sample Program Objectives and Corresponding Evaluation Questions 

Objectives Evaluation Questions 

Advertising Component 

Process Objective 

By the end of 2003, an ad for a branded 

state counter-advertising campaign 

aimed at youth will have been aired on 

TV to reach 80 percent of 12- to 17-yearolds an average of six times per fourweek period. 

Did youth react positively to the ad in the campaign during 

the formative research? 

Based on the TV show ratings during which the ad was

broadcast and its corresponding reach of the audience, were 

at least 80 percent of the 12- to 17-year-olds theoretically

exposed to the ad at least six times? During which time 

periods was the ad aired? 

Outcome Objective 

By the end of 2003, 60 percent of 12- to 

17-year-olds will confirm their awareness 

of one or more of the TV ads in the state 

youth advertising campaign, and 50 

percent will correctly recall the main 

message(s). 

Decrease the proportion of high school 

youth who report trying a cigarette from 

40 percent in 2001 to 30 percent in 2003. 

Among 12- to 17-year olds, were 60 percent or more aware of 

the ad? 

Were 50 percent or more able to recall the message? Were there 

differences in awareness and recall that were based on sex, age, 

or ethnic background of the youth? 

Did the proportion of high school youth who initiated cigarette 

smoking decrease from 40 percent to 30 percent? 

Were there differences in the decrease of initiation of cigarette 

smoking that were based on the sex, age, or ethnic background 

of youth? 

How does the change in youth initiation of cigarette smoking in 

the state compare with that in the nation? Can some of the 

change be confidently attributed to the advertising campaign? 

Continues 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 123 
Table 5.1: Sample Program Objectives and Corresponding Evaluation Questions (cont.) 

Objectives Evaluation Questions 

Public Relations Component 

Process Objective 

By the end of 2003, representatives from 

the top 10 print and broadcast media 

outlets will have been reached with 

counter-marketing messages at least five 

times through phone, mail, and press 

conferences; five of these media outlets 

will have included these messages in 

their coverage and 50 percent of the 

target audience will have been exposed 

to the messages. 

Were the required number of media representatives reached 

the designated number of times? 

Did the required number of media outlets cover the countermarketing messages? 

How well were the messages covered (e.g., how much space 

and time for stories with protobacco slant and for stories with 

antitobacco slant)? 

Which outlets responded? 

How many target audience members were exposed to 

these messages? 

Outcome Objective 

Increase the target audience’s awareness 

of counter-marketing messages in media 

outlets by 25 percent from 2002 to 2003. 

Did the target audience increase its awareness of countermarketing messages by 25 percent? 

Media Literacy Component 

Process Objective 

By December 2003, at least 1,000 middle 

school children will have been reached 

with media literacy sessions through 

programs offered in 10 schools and 

through 10 youth-serving organizations 

in the state. 

Were media literacy sessions offered in the designated number 

of schools and organizations? Did these sessions reach the 

required number of children? 

What were the ages, gender, and race/ethnicity of the 

children reached? 

Outcome Objective 

Increase by 50 percent the number 

of program participants who can 

competently deconstruct a tobacco 

industry ad and produce their own 

counter-marketing message. 

As a result of the program, did participants increase their media 

literacy skills sufficiently to be able to deconstruct industry ads 

and develop tobacco counter-marketing messages? 

124 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

and corresponding evaluation questions for each 

component (e.g., Table 5.1). This table will help 

you take the next step of determining the studies 

that should be in your portfolio. 

3b: Select the evaluation design. 

The evaluation design is the structure or plan 

for data collection that specifies which groups 

will be studied and when. The design you 

select influences the timing of data collection, 

how you analyze the data, and the types of 

conclusions you can draw from your findings. 

Choosing the appropriate evaluation design is 

particularly important if you’re planning an 

outcome evaluation. Outcome evaluation tests 

the effectiveness of an intervention, and the 

evaluation design’s strength will affect your 

ability to attribute change to the intervention. 

Because you may be under considerable 

pressure to demonstrate the effectiveness of 

your program—especially the advertising 

component—your evaluation team needs to 

be familiar with various designs. This section 

touches briefly on various designs, but you 

may also need to consult other resources to 

help you make decisions about study design 

(Campbell and Stanley 1963; Spector 1981; 

Wimmer and Dominick 1987; Fletcher and 

Bowers 1988; Flay and Cook 2001; Rice and 

Atkins 2001; Hedrick et al. 1993; Hornik 1997; 

Rothman and Greenland 1998; Siegel and 

Doner 1998; Freimuth et al. 2001). Feasibility, 

scientific appropriateness, and costs must be 

considered in selecting a design, as well as 

your immediate and longer-term needs for 

data collection. You’ll also need to know your 

stakeholders’ standards, so you can choose a 

design that meets those standards. 

Evaluation designs can be broadly divided into 

three types: experimental, quasi-experimental, 

and observational. As CDC (2001) notes, 

“Experimental designs use random assignment 

to compare the effect of an intervention in one 

or more groups with the effect in an otherwise 

equivalent group or groups that don’t receive 

the intervention.” For example, you could 

identify a set of schools willing to participate in 

an outcome evaluation of a media literacy 

curriculum. One-half of the schools could be 

randomly assigned to begin to use the 

curriculum immediately (test group) and onehalf to use it after the study is completed 

(control group). 

An experimental design is often unrealistic for 

a counter-advertising campaign, because 

exposure to the message is widespread and 

you can’t control who gets it. Many times, 

people have ethical concerns with experimental designs, because interventions are at 

least temporarily withheld, during the time of 

the study, from those who need them. To determine whether you need an experimental 

design for an outcome evaluation of your 

counter-marketing program, consult an expert 

and consider issues such as scientific appropriateness and costs. 

Many program managers find a quasiexperimental design easier to use than an 

experimental design, but a quasi-experimental 

design is not as scientifically strong. CDC 

(2001) comments that “this design makes 

comparisons between nonequivalent groups 

and doesn’t involve random assignment to 

intervention or control groups.” A simple 

example of a quasi-experimental design would 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 125 
be measuring the attitudes, beliefs, and 

behaviors of two communities, one of which 

chose to conduct a counter-marketing 

campaign and the other had no intervention. 

The community with no intervention would be 

selected for its similarity to the first community. 

According to CDC (2001), “Observational 

designs include, but are not limited to, timeseries analysis, cross-sectional surveys, and 

case studies.” Case studies are generally 

descriptive and exploratory. If your program or 

your application is unique or you’re working in 

an unpredictable environment, you might 

want to consider a case study. Case studies are 

often used to evaluate media advocacy 

projects, to provide an in-depth examination 

of how media coverage on a particular topic 

was framed and how community advocates 

were involved in the media advocacy 

initiatives (Wallack et al. 1999). Cross-sectional 

surveys, such as the Youth Tobacco Survey 

(YTS) and surveys performed using a timeseries analysis, can be conducted with a target 

audience to help determine whether the 

desired outcomes of your counter-marketing 

program (e.g., reduced tobacco use) have been 

achieved. Cross-sectional surveys are administered to independent samples of the target 

population. For a time-series analysis, the 

target population is surveyed a number of 

times both before and during program implementation. Although this type of analysis can 

require considerable resources and time, the 

more times the target population can be 

surveyed and the more closely the timing of the 

survey can mirror the timing of your intervention (e.g., through ads in a paid media 

campaign) the more confident you can be that 

the changes in program outcomes are to some 

extent attributable to the program. 

Step 4: Gather credible evidence. 

So far, you’ve written measurable objectives, 

developed a logic model, selected the types of 

evaluation and the evaluation questions, and 

determined the study design(s) you’ll use. The 

next step is to decide on specific outcomes to 

address and identify the indicators you’ll use 

to measure progress. Once these are in place, 

you’ll be ready to figure out which sources of 

data and data collection methods should be 

used to obtain the information you need. 

4a: Develop outcomes and identify 

indicators. 

By now, you should have decided what kind of 

outcome evaluation you’ll conduct and which 

components of the counter-marketing program 

will be addressed in the evaluation. Make sure 

that the outcomes you choose reflect the 

evaluation’s purpose(s), audience(s), and the 

intended uses of the results and that they’re 

relevant to the component(s) you’re studying. 

If your ad campaign has been running for an 

extended period and the legislators want to 

know whether youth smoking has decreased 

and the campaign is worthy of continued 

funding, then behavioral outcomes should be 

the evaluation’s primary focus. 

After you’ve selected the outcomes, determine 

which indicators you can use to show whether 

you’ve achieved these outcomes. Indicators are 

specific, observable, and measurable 

126 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

characteristics or changes that show the 

progress a program is making toward achieving 

a specified outcome (Campbell and Stanley 

1963; CDC 1999b; CDC 2001). Indicators 

translate general concepts related to the 

program, its content, and its expected effects 

into specific measures that can be interpreted. 

For example, the percentage of high school 

youth who report that they’ve tried smoking a 

cigarette, even a puff or two, is an indicator that 

can be used to measure the long-term outcome 

of efforts to decrease smoking among youth. 

Also, the percentage of high school youth who 

report that tobacco companies deliberately use 

advertising to get them to start smoking is an 

indicator of the short-term outcome of efforts 

to increase negative beliefs about the tobacco 

industry. 

Each outcome should have at least one 

indicator, and each indicator should measure 

an important dimension of the outcome. You 

must be specific about what each indicator will 

measure. Indicators define the criteria you’ll 

use to judge your progress in achieving the 

desired outcomes. You can assess behavior in 

several ways. Identifying the best indicator 

depends on the type of behavioral outcome 

you’re addressing. Indicators that may be 

useful for monitoring long-term trends in 

smoking prevalence (e.g., “whether a person 

smoked 100 cigarettes in his or her lifetime”) 

will yield a different estimate of behavior than 

indicators that are appropriate for evaluating 

the impact of a counter-advertising campaign 

on a population (e.g., “on how many of the past 

30 days a person smoked”). 

4b: Collect data. 

Next, you’ll need to decide which methods to 

use to gather data about your outcomes and 

indicators. Each method has advantages and 

disadvantages. Some methods are appropriate 

for process evaluation; others are appropriate 

for outcome evaluation. A number of common 

data-collection tools and methods are used for 

process evaluation, outcome evaluation, or 

both. (See Appendix 5.2: Key Data Collection 

Tools and Methods.) 

Try to use methods that your stakeholders 

perceive as credible. Some stakeholders may 

want you to use an interview method to gather 

qualitative feedback from the community; 

others may want you to conduct an extensive 

population-based survey. Be prepared to 

explain the value of more rigorous methods to 

stakeholders less familiar with evaluation. 

Consider conducting a custom survey. 

Surveys are likely to be part of every countermarketing evaluation. They can be roughly 

divided into two types: (1) primary data surveys 

(custom surveys), which are designed for your 

specific needs, and (2) secondary data surveys, 

which must be used as they are, because they 

have been developed by other individuals or 

organizations for particular purposes. 

Primary data surveys. In most states, some 

form of primary data collection will be needed 

to evaluate the specific outcomes of the 

counter-marketing efforts, particularly the 

advertising component. Although surveys for 

collection of primary data can be expensive, 

they have many advantages. These surveys can 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 127 
be customized with specific items, sampling 

plans, and timing of administration to fit your 

counter-marketing campaign. You can track 

awareness of your specific ads and themes, the 

attitudes and beliefs relevant to your campaign, 

and behaviors in your target population. These 

data can be used to help you make decisions 

about how to improve and when to change the 

campaign. Many states have used custom 

surveys to demonstrate the effectiveness of 

their counter-advertising efforts. 

Depending on your resources, you should 

consider custom surveys for each of the large 

components of your counter-marketing 

program. Alternatively, one way to integrate 

the outcome evaluation of several components 

is by conducting a customized survey to assess 

the full range of audience outcomes for all 

components of your counter-marketing 

(advertising, news articles and stories, 

grassroots events, media literacy, and media 

advocacy). This approach may appear to be 

more efficient, but it may not yield the same 

quality of data that could be generated from 

conducting an individual survey on each 

component. 

In most cases, you should contract with an 

outside expert to design a customized survey 

for use in collecting these primary data. For 

assistance in finding and working with an 

appropriate contractor, states may consult 

with their CDC project officers. A good way to 

start work on a survey is to discuss with your 

evaluation expert questions associated with 

design, sampling and sample size, measurement, and data collection and analysis. (See 

Table 5.2 for sample questions.) Your survey 

probably will measure variables such as the 

target audience’s awareness and recall of the 

counter-marketing messages and the attitudes, 

beliefs, intentions, and behaviors related to 

tobacco use. (See Appendix 5.3 for sample 

survey items.) Another resource is primary 

surveys that have been developed to evaluate 

other state counter-marketing campaigns. 

Some research methods require Institutional 

Review Board (IRB) approval. Nearly all government agencies, academic institutions, and 

other organizations require an assessment of 

the impact on human subjects involved in 

qualitative and quantitative research, including the protection of collected data. Some datacollection efforts are exempt from IRB 

approval. For each research project undertaken, it is recommended that you consult the 

IRB expert in your organization. 

Secondary data surveys and data collection 

systems. All states have access to secondary 

data, particularly on behavior. Several 

secondary data sets are described in CDC’s 

Surveillance and Evaluation Data Resources for 

Comprehensive Tobacco Control Programs (Yee 

and Schooley 2001). These sources may 

include data that can be disaggregated at your 

state’s level. Sources include the following: 

■	 Adult Tobacco Survey 

■	 Behavioral Risk Factor Surveillance 

System 

■	 Current Population Survey Tobacco Use 

Supplements 

■	 Monitoring the Future 

128 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 5.2: Questions To Ask in Designing a Survey To Evaluate Counter-Marketing Efforts 

Design: How should I structure the study? 

• How should I establish control or comparison points against which I can assess impact? 

• When and how many times do I want to survey people? 

• Should I survey the same or different people each time? 

Sampling: Whom should I study, and how should I select the study participants? 

• Whom should I survey? 

• What sampling plan should I use? 

• How many people should I survey? 

• How large a sample do I need to make the comparisons I want to make with sufficient statistical power? 

Measurement: What questions should I ask, and how should I ask them? 

• What variables do I need to measure? 

• How many items do I need for each variable? 

• How do I ensure that my measures are reliable and valid? 

• Do I create my own items, or can I use someone else’s items? 

Data collection: How should I collect the data? 

• Should I collect custom data or use existing data? 

• How should I administer my survey? 

• How can I ensure a high response rate? 

• What data do I need in addition to survey data? 

Analysis: How should I analyze the data to answer the evaluation questions? 

• Which descriptive statistics should I use to help describe and summarize the data (e.g., frequency 

data, raw numbers, and percentages)? 

• Which inferential statistics should I use to allow generalization from my sample to a wider population 

and to enable me to test hypotheses that the data are consistent with research predictions? 

• What analyses can I conduct to determine whether the program is effective? 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 129 
■	 National Health Interview Survey 

■	 National Household Survey on 
 

Drug Abuse 
 

■	 Pregnancy Risk Assessment 
 

Monitoring System
 

■	 State Tobacco Activities Tracking and 

Evaluation System 

■	 Youth Risk Behavior Surveillance System 

■	 Youth Tobacco Survey 

Although these secondary sources are unlikely 

to be ideal for evaluating your countermarketing program, they can provide 

important information on trends, especially 

for attitudes, intentions, and behaviors. In 

many states, current studies can be modified 

to make them more relevant to the countermarketing component. It might be possible to 

add items or modules, modify the sampling 

plan, increase the sample size of some 

segments, or adjust the timing. Alternatively, 

you could time the launch of your program to 

fit the timing of the routine collection of data. 

Early in the planning of your evaluation, 

review what secondary sources are available in 

your state and see if they would improve your 

evaluation. For example, many states conduct 

the Youth Risk Behavior Survey (YRBS), a 

school-based survey of youth risk behaviors. 

The instrument includes several items on 

smoking behavior that can be used to track 

long-term trends and provide state-level 

estimates of students in grades 9 through 12. 

National data are available for comparison, and 

data from nearby states also might be available. 

Disadvantages of these data are that they are 

collected only every two years, in the spring, 

and that the instrument assesses only behavior. 

The YRBS could be and has been enhanced in 

many states by adding questions. Vermont, for 

example, has added items that help (1) to 

measure how easy it is for youth to get cigarettes and (2) to assess youths’ opinions of their 

parents’ attitudes toward their own cigarette 

use. Alabama has added an item that helps to 

determine whether a youth’s health care 

provider addresses tobacco use prevention. For 

some states, the YRBS might prove to be a 

useful data source to include in portfolios. 

Step 5: Justify conclusions. 

Once the data are gathered, you’ll need to 

analyze and interpret the data and formulate 

conclusions and recommendations. Your 

analysis and interpretation should be related 

to the evaluation questions. Essentially, analysis 

and interpretation are a matter of tracking 

what happens along each step of the logic 

model. (See Table 5.3 for the key evaluation 

questions in tobacco counter-marketing and 

examples of data analysis approaches for each 

question.) 

130 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 5.3: Evaluation Analysis 

Evaluation Questions Data Analysis Approach 

Process Evaluation: Is the state’s counter marketing program being implemented as planned? 

Are the program activities being conducted 

at the planned level (quantity and quality)? 

• Summary of data on the number and quality of media 

literacy sessions conducted 

Are members of the target population 

exposed to the ad and participating in 

the program? 

• Summary of ratings of TV shows during which paid 

counter-advertisements were aired 

• Summary of data on the number of participants in a 

youth summit 

Short-Term Outcome Evaluation: Is the state’s counter-marketing program having the intended effects? 

Who is aware of the ad? Who is aware of 

the program? 

Are all segments of the target population 

aware of the ad? Are all segments aware of 

the program? 

• Collecting data on the percentage of the state’s adult voters 

who recalled seeing a story or article about tobacco in a 

newspaper or magazine in the past month 

• Obtaining data on the percentage of 12- to 17-year-olds 

who reported seeing one of the state’s counter-marketing 

ads in the past month 

• Acquiring data on the level of awareness of the campaign’s 

brand among youth by gender, age, race/ethnicity, and 

community 

• Collecting data on the percentage of restaurant owners 

who reported knowing about the state’s policies on 

secondhand smoke 

Is the right message getting across? • Obtaining data on the percentage of participants who were 

aware of the advertising campaign and could correctly 

recall the intended message 

• Acquiring data on the percentage of the articles on the 

counter-marketing theme that conveyed the intended 

message 

How is the target population’s awareness 

of the program changing over time? 

How is it changing in relation to specific 

counter-marketing efforts? 

• Tracking data at several points over time to indicate (1) the 

percentage of the state’s population that is aware of the 

counter-advertising campaign; (2) whether the percentage 

is higher immediately after the counter-marketing efforts; 

and (3) when the percentage starts to decrease, suggesting 

that the effects of the state’s ads have peaked or that the 

state has reduced its media buying 

Continues 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 131 
Table 5.3: Evaluation Analysis (cont.) 

Evaluation Questions Data Analysis Approach 

Short-Term Outcome Evaluation: Is the state’s counter-marketing program having the intended effects? 

Are attitudes, beliefs, and other 

psychosocial factors moving in the 

desired direction? 

• Pretest and posttest tracking of data (1) on restaurant owners’ 

belief that secondhand smoke is harmful to health and (2) on 

the public’s attitudes toward policies on exposure to 

secondhand smoke 

Is behavior changing? • Tracking data at several points over time that indicate the 

percentage of high school students who reported trying a 

cigarette or using chewing tobacco 

• Tracking data at several points over time that indicate the 

percentage of smokers who reported trying to quit smoking 

Are the counter-marketing efforts 

contributing to the changes in attitudes, 

beliefs, policies, and behavior? 

• Collecting data to address whether change can be attributed 

to the intervention: (1) the percentage of participants who 

believe in negative health consequences of smoking, among 

those who are aware of the state’s ads on health consequences 

versus those who are not aware and (2) the percentage who 

understand the tactics of tobacco advertising, among those 

who participated in the media literacy workshop versus those 

who did not participate 

• Monitoring data on tobacco-related policies to document 

their stage of development, implementation, and enforcement, 

and comparing the timing of these stages with the timing of 

activities in the tobacco counter-marketing campaign 

As part of the state’s entire tobacco 

control program, do the state surveillance 

data indicate progress toward goal(s)? 

Long-Term Outcome Evaluation: Is the state counter-marketing program achieving its long-term goals? 

• Monitoring surveillance data on the prevalence of smoking 

or public exposure to secondhand smoke and comparing 

these data with data from the tobacco control program 

(customized survey) 

Descriptive Analyses 

Analysis and interpretation of your process 

evaluation data will be descriptive. The data 

will consist of raw numbers and percentages 

(e.g., frequency data) that simply describe the 

level of activities and outputs that have taken 

place. As a manager, you’ll want to review 

monthly reports on each component, to 

ensure that the activities are being implemented as planned. Relevant questions 

include the following: 

■	 Is the public relations specialist conducting all the planned press activities? 

132 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Have quitline operators been 
 

trained appropriately? 
 

■	 Are all the media literacy sessions 
 

being held? 
 

■	 Have the ads been designed, tested, 

and produced? 

■	 Is the state on target in its media buying? 

If the expected level of activity isn’t being 

achieved, you need to determine what needs 

to be done to ensure that the necessary 

resources and support are available. 

As another descriptive analysis, you’ll want to 

determine whether the program is reaching 

enough people. Are audience members aware 

of the advertising campaign? Are enough 

articles and editorials being published? Look at 

the quality of the reach as well as the quantity. 

You’ll need to know not only the column 

inches and placement of the ad coverage, but 

also its content and slant. (See Chapter 7: 

Advertising and Chapter 8: Public Relations for 

more information.) If the intended message 

isn’t getting across, you may need to modify 

your materials or your approach. 

Although this type of tracking of the campaign’s 

reach is more a matter of management than 

evaluation, it’s a critical step. If the outcomes 

of intervention are not ultimately achieved, it 

may be simply because the intervention was 

not implemented as planned. The regular 

review of these descriptive data will help you 

to monitor your implementation efforts. 

Comparative Analyses. Beyond descriptive 

analyses, you’ll also want to perform comparative analyses to determine whether your 

program is successful. In conducting comparative analyses, you’ll need to use inferential 

statistics to determine whether the differences 

you observe are great enough to be statistically 

significant. Consider at least four types of comparisons: over segments of your target population, over time, over regions, and over levels of 

awareness of the counter-marketing effort. 

Analyses by segments. Comparisons of levels 

of awareness, attitudes, beliefs, and behaviors 

by segments of your target population will tell 

you whether you’re reaching a substantial 

proportion of each segment and how your 

efforts are influencing each segment. Consider 

analyzing the data by gender, age, and race/ 

ethnicity. Counter-advertising programs with 

youth, for example, sometimes have been 

found to be more effective with those younger 

than 16 than with those 16 or older. Early 

analyses by race/ethnicity demonstrated to 

some states that they weren’t influencing some 

segments of their target population. The media 

buys, media outlets, and messages needed to 

be adjusted. 

Analyses by time. Comparisons over time will 

show you how the awareness, reach, and effect 

of your program are increasing with time, the 

level of your program activities, or both. Some 

variables should change gradually, and others 

should change abruptly. For example, the 

proportion of the population that is smoking or 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 133 
the percentage of youth that has tried a cigarette should decline gradually and smoothly. 

This result is most likely when, at the onset of 

the program, there is a large pool of 

“susceptibles” made up of individuals who 

have not been reached by similar interventions. 

Levels of exposure to the activities of your 

counter-marketing campaign increase as the 

program gradually scales up. After you run 

articles and ads about industry manipulation 

in your state, there should be sudden increases 

in awareness of the ads and a subsequent increase in the belief that the industry is trying to 

influence consumers to buy cigarettes. Examine the pattern of results with respect to time 

and the timing of your program activities. After 

the most receptive members of the population 

have been influenced by program messages, 

leaving the more resistant ones, results will 

show a slowdown in measurable improvement. 

Analyses by region. You can also examine the 

pattern of awareness, beliefs, attitudes, and 

behaviors by region. If the different regions of 

your state have different amounts of program 

activity, this difference should show up in the 

findings. In Texas, for example, countermarketing managers purposely implemented 

different patterns of programs in different 

communities, to evaluate the programs’ effects. 

In 14 areas across the state, they implemented 

a mix of three levels of media activity (no 

campaign, low-level campaign, or high-level 

campaign) and five community program 

options (no programs, cessation programs, law 

enforcement programs, school-community 

programs, or all three programs combined). 

Their evaluation found a significant relative 

reduction in the prevalence of daily smoking 

in the areas where a high-level media campaign was conducted in combination with 

either school-community or multiple programs 

(Texas Tobacco Prevention Initiative 2001). 

Analyses by level of awareness of the countermarketing effort. A common approach for 

analysis to evaluate counter-marketing efforts, 

particularly counter-advertising, is to compare 

attitudes, beliefs, and behaviors in different 

groups by level of awareness of advertising. 

Such analysis can help you determine whether 

there have been more positive changes in 

attitudes, beliefs, and behaviors among those 

who are aware of the program than among 

those who aren’t aware. 

Attribution in Outcome Evaluation 

Finding change is not conclusive evidence that 

the change is attributable to the effectiveness 

of your program. To demonstrate that a 

program is effective, you need data that show 

(1) a change or difference, and (2) that your 

program was to some extent responsible for 

that change or difference. 

The first part is relatively simple. By conducting surveys before and after your programs, 

you can show increases in awareness and 

desirable changes in attitudes, beliefs, and 

behaviors over time. By comparing levels of 

attitudes, beliefs, and behaviors across levels 

of exposure to a program, you can show that 

people exposed to the program have better 

outcomes. By comparing people in regions 

where programs were implemented to those in 

regions where they weren’t implemented, you 

can show better attitudes, beliefs, and behaviors in areas with the programs. 

134 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

The second part is difficult. Methodologically 

sophisticated stakeholders can and do criticize 

each of the analyses described and claim the 

changes or differences observed could have 

resulted from factors other than the countermarketing program. Critics can correctly claim 

that the differences or changes result from 

factors such as general trends in smoking, 

policy and pricing changes in the state, 

national media campaigns, or changes in the 

activities of the tobacco industry. 

As noted earlier, it’s usually not feasible to use a 

true experimental design with random assignment to evaluate your counter-advertising 

component, because it’s difficult to control 

who is exposed to what. But there are some 

things you can do to avoid criticism of the evaluation. From a process perspective, you can: 

■	 Find out early if your stakeholders 

want a rigorous assessment of the 

degree to which the counter-marketing 

program was responsible for changes 

or differences 

■	 Allocate additional resources for 
 

that assessment
 

■	 Alert your evaluation experts, and discuss the alternative methods with them 

■	 Find out what other states have done 

■	 Arm yourself with high-quality studies 

from a variety of sources showing that 

strong counter-marketing efforts 

generally can lead to better outcomes 

■	 Be prepared to answer questions about 

attribution when you present your 

results 

From a technical or analytic perspective, your 

evaluation team can: 

■ 

■	 

■	 

■	 

Conduct several types of analyses to 

demonstrate change. For example, 

(1) show change from time A to time B; 

(2) show better outcomes among people 

who are exposed to counter-marketing 

activities than among those who aren’t 

exposed; and (3) compare results for 

your state with those for areas of the 

country that have fewer or different 

counter-marketing programs. 

Perform complex multivariate analyses. 

For example, you can determine the 

effects of multiple independent 

variables (e.g., timing of the ads and 

changes in awareness, attitudes, and 

beliefs) on the dependent variable (e.g., 

change in smoking behavior), controlling for the effects of other variables 

(e.g., gender, age, and race/ethnicity). 

Measure attitudes, beliefs, and behaviors that you expect to be influenced by 

your program, as well as those that you 

do not expect to be changed. Then show 

that the differences for the items specific 

to your program are greater than the 

differences for the other items. 

Conduct a longitudinal study that 

follows a cohort across time in order to 

show the causal chain of effects. This 

approach allows you to conduct more 

complex analyses to determine whether 

the degree of program exposure is 

associated with changes in attitudes and 

beliefs, and whether the changes in 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 135 
attitudes and beliefs are associated with 

changes in behavior. 

■	 Perform a quasi-experimental study to 

assess the impact of different program 

components that have been implemented in different communities in 

your state. This approach can help you 

determine how much different program 

components have changed attitudes, 

beliefs, and behaviors. 

Step 6: Ensure use of results and share 

lessons learned. 

The main purpose of your evaluation is to 

produce findings that will help to inform your 

decision making and help you to be accountable to stakeholders. Despite the potential 

usefulness of an evaluation, however, its 

findings, conclusions, and recommendations 

don’t automatically translate into informed 

decision making and appropriate action. You 

must have a plan for making sure that the 

evaluation results are disseminated in a timely 

and understandable fashion and that they are 

used to improve programs and to help ensure 

support and funding for future programs. Each 

of the steps in the evaluation process must be 

executed in a way that ensures use. 

6a: Develop a clear and focused 

evaluation plan. 

The first step in using results is to have a clear 

evaluation plan that links the program 

objectives, the evaluation questions, and the 

methods. Linking the data source to the 

question not only helps you to keep your data 

collection pared down to the essentials, it also 

keeps you aware of the data’s value in decision 

making. 

6b: Consider the implications of different 

results. 

In collaboration with your stakeholders, 

consider the decisions that would be made on 

the bases of specific patterns of results. During 

different stages of evaluation planning, pose 

various hypothetical results and discuss their 

implications for modifying the program. If no 

action would be taken, you might need to 

rethink the proposed evaluation plan to make 

sure you’re asking the right questions. 

Consideration of the possible results also 

allows stakeholders to explore the positive and 

negative implications of those results and gives 

them time to develop options. 

6c: Communicate with stakeholders 

during each step of the evaluation 

process. 

Let all interested parties know how the 

evaluation is going. Involve them in the 

evaluation planning, in an effort to manage 

their expectations about what questions the 

evaluation will answer and when. Keep them 

informed, and hold periodic discussions about 

interim results, early interpretations, draft 

reports, and the final report. 

136 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

6d: Follow up with stakeholders to 

ensure that results are used in 

decision making. 

the evaluation team is needed to remind 

stakeholders of the intended uses for the 

results and to help prevent results from being 

lost or ignored when complex, politically 

sensitive decisions are being made. 

Efforts to make sure that results are used don’t 

end with a final report that reaches conclusions 

and makes recommendations. Follow-up by 

Tips for an Effective Evaluation Report 

■	 Include an executive summary. 

■	 Describe the stakeholders and how they were involved. 

■	 Describe the essential features of the program, including the logic model. 

■	 Outline the key evaluation questions. 

■	 Include a description of the methods. 

■	 List methodological strengths and weaknesses. No study is perfect; don’t pretend yours has no flaws. 

■	 Present results and conclusions. 

■	 Put results into context. (Help readers to understand what is reasonable at this point and how the 

results should be interpreted.) 

■	 Translate findings into recommendations. 

■	 Organize the report logically. 

■	 Minimize technical jargon. 

■	 Provide detailed information in appendices. 

■	 Use examples, illustrations, graphics, and stories. 

■	 Involve stakeholders in preparation of the report. 

■	 Consider how the findings might affect others. 

■	 Develop additional communication products suited to a variety of audiences, for sharing the results. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 137 
6e: Use a variety of channels and 

approaches in disseminating results. 

Dissemination is a form of communication. 

As with any communication, you should 

consider the target audience and purpose 

when deciding how to disseminate the results. 

Some people connect with numbers, some 

with text, some with graphs and pictures, and 

some with stories. 

You should also think about the timing of the 

release of your results: 

■	 Who should receive results first? 

■	 When should the media be notified? 

■	 How often should each set of
 

stakeholders receive results? 
 

■	 Who should release results to 
 

which audiences?
 

In addition, consider the potential criticisms 

that your results may receive. You may present 

a certain percentage decline in tobacco use as a 

success, but others may see that same decline 

as a failure. You should prepare responses to 

any potential criticisms you foresee and train 

your spokespeople to respond to attacks on 

your campaign. Stakeholders can be especially 

valuable in defending your results. For more 

information on preparing for and responding 

to media inquiries, see Chapter 9: Media 

Advocacy and Chapter 8: Public Relations. 

A formal evaluation report shouldn’t be the 

only product you disseminate. Work with 

various stakeholders to develop other products 

and to make sure the products’ timing, style, 

tone, message, and format are appropriate for 

their audience(s). For example: 

■	 Consider providing a briefing sheet that 

public health officials can use in presentations to state legislatures. 

■	 Work with the public relations staff to 

develop materials for the news media. 

■	 Consider a press conference to 
 

release results. 
 

■	 Hold a community forum. 

■	 Provide materials with more details, 

containing statistics and other data for 

technical audiences. 

■	 Arrange to summarize key findings or 

complete reports and instruments on 

Web sites. 

■	 Make your findings, reports, and 

materials available to other states and 

other people involved in tobacco 

control and prevention. 

These ideas can help to ensure that your 

evaluation efforts don’t go to waste. Again, 

your evaluation is useless if the results aren’t 

understood and used to make decisions about 

the program. 

138 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Points To Remember 

■	 

■	 Build an effective evaluation team. The evaluation team should include counter-marketing staff, 

evaluation expertise, and stakeholder input. At the state level, the program manager should be 

responsible for putting the team together. Make sure the team has sufficient expertise in technical 

evaluation and that it includes an external evaluator who is perceived by stakeholders as objective 

and capable. Many states have found it helpful to have a mix of experts from different backgrounds, 

such as a market researcher from the corporate sector, a public health epidemiologist, and a 

university-based communication researcher. Stakeholders are important to program evaluation, 

because their support of the process, results, and recommendations will help to ensure that the 

evaluation is accepted and used. Without stakeholder involvement, the evaluation may lack 

credibility, and the findings may be ignored. 

■	 

■	 

■	 

■	 

Consider evaluation early and often. Evaluation shouldn’t be left until the end of the program. 

Considering evaluation while the program is being planned helps to ensure that the plan is specific 

and clear about what the program is trying to achieve. Developing a logic model that links inputs to 

activities to outputs and, finally, to outcomes forces planners to articulate their assumptions about 

how the program will work. These assumptions can be reviewed to determine whether they’re 

consistent with available evidence. Considering evaluation before you begin to implement your 

program also helps to ensure that baseline data are collected. 

Although you may be pressured to roll out your program quickly, if you don’t collect baseline data, 

you’ll never be able to clearly measure the changes caused by your intervention. Regular monitoring of activities and outputs helps the counter-marketing manager to troubleshoot and make 

adjustments in the program. Assessing short-term outcomes helps in modifying the program, and 

assessing long-term outcomes is necessary for accountability and to ensure continued funding for 

the program. 

Develop and follow an evaluation plan that is appropriate to your state in terms of context, 

timing, cost, and rigor. In evaluation, one size doesn’t fit all. There’s no one best evaluation plan. 

Different states will face different marketing challenges, will have different resources, and will be working 

in a different context. The evaluation plan should reflect these factors. As a general rule, you should 

allocate 10 percent of your resources to evaluation. Evaluate as rigorously as your resources allow, and be 

sure to use more rigorous evaluation methods when the programs are more costly, visible, or controversial. 

Make sure findings are shared and used. Evaluation that ends as a report sitting on a shelf is wasted. 

Evaluation findings must be shared in such a way that they inform program decisions. Ensuring the 

use of results begins in the early stages of planning, as you ask what the program’s objectives are, 

what questions need to be answered, and how the results will affect decisions. The evaluation 

report is a communication, so it must be appropriate for the audience. 

Build on what others have learned. In conducting outcome evaluation for your counter-marketing 

program, you may encounter a number of challenges. Fortunately, you’re not alone. Others, such as CDC, 

the American Legacy Foundation, and other states, have faced the same issues and have begun to develop 

solutions. Talk to others, read the literature and reports, and share your experiences. 

Consult other CDC resources. This chapter provides a brief overview of what you should consider in 

evaluating a counter-marketing program. Consider reviewing other CDC resources and consulting 

your CDC project officer for specific advice. Seeking these resources and specific advice is especially 

important if you’re conducting an outcome evaluation of a paid media campaign. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 139 
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